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Signature Title <br /> Date: <br /> Reason(s) for revocation: <br /> TO BE REVIEWED/APPROVED AND SIGNED BY AFFECTED <br /> CITY DEPARTMENT HEADS <br /> 2. PARKS AND RECREATION DEPARTMENT <br /> Special Events Coordinator: Date: <br /> Initial/sign-off- <br /> 3. POLICE DEPARTMENT <br /> Approved by: <br /> Signature Title <br /> Date: <br /> 1. Emergency vehicle access. <br /> 2. Traffic/safety street closures. <br /> 3. Appropriate barricades. (# Required) <br /> 4. Police personnel required/available. <br /> 5. Portable toilet facilities. (# Required) <br /> 6. First aid facilities. <br /> 7. Internal security and crowd control. <br /> 8. nighttime lighting. <br /> 9. Other provisions as may be required by this department. <br /> Page 10 of 14 <br />